Kenny Khoi Ao
Individual provider Active NPI Pharmacist · Brookhaven, PA
NPI 1265080378 · NPPES record last updated Sep 2, 2019
Key facts
- NPI
- 1265080378
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP453928 (PA)
- Practice address
- 4098 Edgmont Ave
Brookhaven, PA 19015-2211 - Phone
- (610) 876-8815
- NPI assigned
- Sep 2, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP453928 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Take Care Health Pennsylvania, PC | Current |
Accepting new patients | |
| Walgreen Eastern Co Inc | Past |
Accepting new patients |
Locations
4098 Edgmont Ave
Brookhaven, PA 19015
Phone (610) 876-8815
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP453928 | PA | Yes |
Addresses
Primary practice location
4098 Edgmont Ave
Brookhaven, PA 19015-2211
Mailing address
6601 Curlew PL
Philadelphia, PA 19142-2616
Phone (267) 467-2175
Other providers in Brookhaven, PA
- Adek Lux
- Samaa Adeli
- Babatunde Adenusi
- Aligned Nutrition by Alyssa LLC
- Mohsen Ghorban Alizadeh
- Asa Caregiving Agency LLC
- Ana Beard
- Behavioral Care Experts LLC
- Kimberly Behling
- David Lionel Berman
All providers in Brookhaven, PA · Pharmacist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.